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<table style="margin:0 auto;" width="600" border="0" align="center" cellpadding="0" cellspacing="0">
<form >
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<table width="600" border="0" align="center" cellpadding="0" cellspacing="0">

  <tr>
    <td colspan="4" align="center" valign="middle" height="80" style="font-size:20px;">客户需求登记单</td>
  </tr>
  <tr>
    <td align="right" valign="middle" width="120">系统名称：</td>
    <td align="center" valign="middle" width="180"><input type="text"/></td>
    <td align="right" valign="middle" width="120">需求书编号：</td>
    <td align="center" valign="middle" width="180"><input type="text"/></td>
  </tr>
</table></td></tr>
<tr><td style="padding:0">
<table style=" border-collapse:collapse;" width="598" border="1" bordercolor="#000000"  align="center" cellpadding="0" cellspacing="0">
  <tr>
    <td align="center" valign="middle" width="120">功能模块名称
</td>
    <td align="center" valign="middle" width="180"><input type="text"/></td>
    <td align="center" valign="middle" width="120">功能组</td>
    <td align="center" valign="middle" width="180"><input type="text"/></td>
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  <tr>
    <td align="center" valign="middle">类别</td>
    <td colspan="3" align="left" valign="middle" width="480">
    <table width="480" id="lb" border="0" cellspacing="0" cellpadding="0">
      <tr>
        <td><input type="checkbox" name="lb" class="lb" />字典修改</td>
        <td><input type="checkbox" name="lb" class="lb" />关联查询修改</td>
      </tr>
      <tr>
        <td><input type="checkbox" name="lb" class="lb" />审批或工作流程修改</td>
        <td><input type="checkbox" name="lb" class="lb" />增加文书</td>
      </tr>
      <tr>
        <td><input type="checkbox" name="lb" class="lb" />数据录入页面增加录入字段</td>
        <td><input type="checkbox" name="lb" class="lb" />页面显示字段名称修改</td>
      </tr>
      <tr>
        <td><input type="checkbox" name="lb" class="lb" />平台操作方式修改</td>
        <td><input type="checkbox" name="lb" class="lb" />系统提示功能</td>
      </tr>
      <tr>
        <td><input type="checkbox" name="lb" class="lb" />新增窗体善</td>
        <td><input type="checkbox" name="lb" class="lb" />原有功能完</td>
      </tr>
      <tr>
        <td><input type="checkbox" name="lb" class="lb" />原有功能删除</td>
        <td></td>
      </tr>
    </table></td>
  </tr>
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    <td align="center" valign="middle">涉及角色或岗位
</td>
    <td colspan="3" align="center" valign="middle"><input style="width:470px;" type="text"/></td>
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  <tr>
    <td align="center" valign="middle">需求提供单位</td>
    <td align="center" valign="middle"><input type="text"/></td>
    <td align="center" valign="middle">需求提供人</td>
    <td align="center" valign="middle"><input type="text"/></td>
  </tr>
  <tr>
    <td align="center" valign="middle">服务单位</td>
    <td align="center" valign="middle"><input type="text"/></td>
    <td align="center" valign="middle">服务人员</td>
    <td align="center" valign="middle"><input type="text"/></td>
  </tr>
  <tr>
    <td colspan="4" align="center" valign="middle">需求描述</td>
  </tr>
  <tr>
    <td colspan="4" align="center" valign="middle"><textarea style="width:580px; height:200px; color:#333; border:0 none; font-weight:normal;"></textarea>
    <p style=" text-align:right; padding:10px 28px 0 0;">日期：<input  style="width:50px;" type="text"/>年<input style="width:50px;" type="text"/>月<input style="width:50px;" type="text"/>日</p>
    </td>
  </tr>
</table></td></tr>
</form>
</table>
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